Fa 4161V Form – Fill Out and Use This PDF

PRINT IN INK
		STATE OF WISCONSIN, CIRCUIT COURT,
Enter the name of the
county in which this case					COUNTY
is filed.
Enter the name of the		In RE: The marriage of
petitioner. If joint		Petitioner/Joint Petitioner-Wife:
petitioners, enter the name
of the wife.
		First name	Middle name	Last name

and

FOR OFFICIAL USE

Enter the name of the respondent. If joint petitioners, enter the name of the husband.

Check divorce or legal separation.

Enter the case number.

Respondent/Joint Petitioner-Husband:

First name

Middle name

Last name

Findings of Fact,

Conclusions of Law, and

Judgment

Without Minor Children

Divorce-40101

Legal Separation-40201

Case No.

In 1, enter the name of the court official who granted the judgment and the address and date [month, day, year] on which it was granted.

FINAL HEARING

A final hearing was conducted in this matter as follows:

1. Before

Circuit Court Judge

Circuit Court Commissioner

2.Location

3.Date

In 1, check how the party appeared.

If b, enter the name of the attorney.

In 2, check how the party appeared.

If b, enter the name of the attorney.

In 3, check a, or b.

If b, enter the name of the individual(s) who appeared.

APPEARANCES

1.	Wife
	appeared in person		appeared by phone			did not appear	AND
	a.	was self-represented.
	b. was represented by Attorney						.
2.	Husband
	appeared in person		appeared by phone			did not appear	AND
	a.	was self-represented.
	b. was represented by Attorney							.

3.Others appearing at the hearing a. None.

b.

Other:

.

In 2, check a or b.

In B.1, enter the requested information about the wife. If you do

not know an answer, enter “unknown” in the

blank.

FINDINGS OF FACT

A.Jurisdiction

1.All necessary parties were properly served and 120 days have lapsed since the

filing of the joint petition or the date of service of the summons and petition, whichever applies.

2.At the time of the final hearing, the parties requested a:

a. Divorce: The court finds the marriage is irretrievably broken.

b. Legal Separation: The court finds the marital relationship is broken and acceptable reasons have been given to the court for the request.

3.All jurisdictional requirements for a judgment have been met. B. Parties (as of the date of the final hearing)

1.The wife in this action is: Name

Address

Address

City				State		Zip
Date of birth
Gross monthly income $

In 2, enter the requested information about the husband. If you do not know an answer, enter

“unknown” in the blank.

In c, check a or b.

In 2, check a or b.

If b, check 1 or 2.

If 2, check A or B.

If B, enter the name of the county and state in which the case is pending and write the case number assigned to it.

2.The husband in this action is: Name

Address Address

City				State		Zip
Date of birth
Gross monthly income $

C.Children

1. a. No children were born to or adopted together by the parties before or during the marriage.

b. All children born to the wife or adopted together by the parties before or during the marriage are as set forth in the petition.

2.The wife

a. is not currently pregnant.

b. is currently pregnant and

1. the husband is found to be the father. STOP! You must use FA-4160

instead of this form.

2. the husband is not found to be the father and the marital presumption in §891.41(2), Wis. Stats. has been rebutted.

A.	A paternity case is not pending.
B.	A paternity case is pending in					county in the state
	of		with case number			.

3.The parties’ assets, their interests, values, and their encumbrances and debts are found to be as stated in the Financial Disclosure Statements, which were updated as required by statute on the record at the time of trial and are on file.

In D, check 1, 2 or 3. If 3, enter the amount and interest rate and check a or b. If a, enter the date. If b, enter payment amount, and the date payments begin.

4.A Marital Settlement Agreement or Proposed Marital Settlement has been submitted. The party(s) have asked that it be approved by the Court. All parties present have been informed of the legal consequences if the Court approves the document in whole or in part.

D.Past Due Maintenance

The amount of the past due arrearages for maintenance at the time of the final hearing is

1. none (zero).

2. as agreed in the Marital Settlement Agreement or Proposed Marital Settlement.

3.

$

which shall earn interest at the rate of

% per year and shall be paid as

a.

a one-time payment to the WI SCTF made by (Date)

.

b.

through monthly income withholding by the WI SCTF in the amount of $

beginning

, 20

until the arrearages are

paid in full.

In A, check 1 or 2 and enter the effective date.

In B.1, check the appropriate boxes and enter the date [month, day, year] that the party(s) signed the checked document and attach the document. If the court made changes, write them in the space provided.

If 1 does not apply, check 2.

CONCLUSIONS OF LAW AND JUDGMENT

A. The Court grants a judgment of
1.	Divorce. The marriage between the parties is dissolved and the parties are divorced
	effective on	date of hearing.	other date:

The parties are informed by the court that under §765.03(2), Wis. Stats.

It is unlawful for any person who is or has been a party to an action of divorce in any court in this state, or elsewhere, to marry again until six months after judgment of divorce is granted, and the marriage of any such person solemnized before the expiration of six months from the date of the granting of judgment of divorce shall be void.

2. Legal Separation. The marital relationship is broken and the parties are granted a judgment of legal separation effective on date of hearing. other date:

The parties are informed by the court that under §767.35, Wis. Stats.:

In case of reconciliation, at any time, the parties may apply for a revocation of the judgment of legal separation.

The court shall convert the decree to a decree of divorce:

by stipulation of both parties at any time, OR

upon motion of either party not earlier than one year after entry of a decree of legal separation.

B. Final Orders
1. The		Marital Settlement Agreement dated			or
	Proposed Marital Settlement dated				of the
	wife	husband is approved, attached and made the judgment of the court except as
	changed below:

2. No Marital Settlement Agreement or Proposed Marital Settlement was approved by the court. A Divorce Judgment Addendum has been prepared to reflect the Judges’ orders, is attached and is made the judgment of the court.

C.Lis Pendens

Any Lis Pendens filed in this action is released.

In D, check 1, 2, or 3.

If 2 or 3, enter the former legal surname.

D. Legal Name Restoration
1.	Neither party is awarded the right to use a former legal surname.
2.	The wife is awarded the right to use a former legal surname of			.
3.	The husband is awarded the right to use a former legal surname of			.

Note: If this is an action for legal separation, the court cannot allow a spouse to resume a former legal surname unless and until the judgment is converted to a divorce.

E.Maintenance

1.Pursuant to §767.75, Wis. Stats., this judgment constitutes an immediate assignment of all commissions, earnings, salaries, wages, pension benefits, benefits under Chapter 102 or 108, and other money due or to be due in the future, to the WI SCTF. The assignment shall be for an amount sufficient to ensure payment under this judgment, so long as the addition of the amount toward arrears does not leave the party at an income below the poverty line established under 42 USC 9902(2).

2.Pursuant to §767.57(1)(a), Wis. Stats., all payments for maintenance ordered shall note the case number and the names of the parties on the face of the check, should be made payable to WI SCTF, and sent to:

Wisconsin Support Collections Trust Fund

Box 74200

Milwaukee, WI 53274-0200

The WI SCTF will transmit the payments to the proper persons entitled to them.

Failure of an employer to pay the proper amount shall not be a defense for failure to pay the proper amount. If an employer fails to take out the correct amount for maintenance, the party paying is responsible for paying the full and correct amount directly to WI SCTF.

Pursuant to §767.57(1e), Wis. Stats., the party making payment for maintenance is responsible for payment of the annual receiving and disbursing fee to WI SCTF.

3.If maintenance is not denied, both parties shall notify, in writing, the other party and the

Clerk of Court and the Child Support Agency of the county in which this action is filed, within 10 business days, of any change of employer and employer’s address.

4.Pursuant to §767.75, Wis. Stats., a withholding assignment or order under this section has

priority over any other assignment, garnishment, or similar legal process under Wisconsin law. The employer shall not withhold more of the employee’s disposable income than allowed pursuant to the Federal Consumer Credit Protection Act unless the employee agrees to have the full amount withheld. No employer may use an assignment under this section to deny employment, or to discharge or take disciplinary action against an employee.

F.Property Division

Notice is given of the provisions of §767.61 (5) (a) and (b) and §767.61(6), Wis. Stats.

The parties shall transfer title to property of the parties as necessary, in accordance with the division of property set forth in the judgment.

The parties are notified that

1.it may be necessary for the parties to take additional actions in order to transfer interests in their property in accordance with the division of property set forth in the judgment, including such interests as interests in real property, interests in retirement benefits, and contractual interests.

2.the judgment does not necessarily affect the ability of a creditor to proceed against a party or against that party's property even though the party is not responsible for the debt under the terms of the judgment.

For Court Use Only.

BY THE COURT:

Circuit Court Judge Circuit Court Commissioner

Print or Type Name

Date

All parties to the action should approve how accurately the form was completed before the judge signs it. The parties must approve by signing in the space to the right.

APPROVED AS TO FORM BY:
			
	Petitioner/ Joint Petitioner-Wife		Respondent/Joint Petitioner-Husband